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U. Bokhary
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P2.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 213)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Locoregional Disease – NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.03-003 - Video Assisted Thoracoscopic Anatomical Resection for Non Small Cell Lung Cancer (NSCLC) Is Increasingly Safe (ID 3055)
09:30 - 09:30 | Author(s): U. Bokhary
- Abstract
Background:
We analyze our institutional clinical data of patients that underwent video assisted thoracoscopic (VATS) anatomical lung resection for Non-small cell lung carcinoma (NSCLC).
Methods:
This is a retrospective analysis from January 1st of 2009 to December 31st of 2013. We extracted the data through standard queries and by manual extraction from the Electronic Data Warehouse of the NorthShore University Health System. The patients were selected based on surgical description of anatomical resection defined as lobectomy, bilobectomy or segmentectomy for proven NSCLC. Patients with more than one procedure performed, diagnosis of carcinoid tumor or incomplete data were excluded. The variables evaluated included demographics, preoperative workup and clinical evaluation, pathology reports, intra-operative data and post-operative outcomes.
Results:
A total of 224 patients were included. The mean age at the time of diagnosis was 70.9 years, 63% were females, 81.5% were Caucasian with a 37 pack-year smoking history. The most common comorbidities encountered were hypertension, COPD and coronary artery disease. Sixty four percent of patients were diagnosed with pathologic stage I, 20.5% with stage II and 13.2% with stage III disease. Eighty nine percent of patients had FEV~1 ~whereas DLCO was available in 83.6% of the patients. VATS lobectomy was performed in 84% of the patients and VATS segmentectomy in 14% of the patients. The mean procedure time was 157 minutes, the median length of chest drainage with tube thoracostomy was 2 days. Twenty three percent of the patients required admission to the Intensive Care Unit (ICU) with a median length of stay in the ICU of 1.1 days. The length of stay in the hospital was 3 days. The overall rate of complications was 30% with atrial fibrillation (17.9%), prolonged air leak (>5 days) (9.8%) and atrial arrhythmia (3.8%) being the most frequent complications. Atrial Fibrillation had a postoperative onset in 50% of the patients whereas 50% of the patients with history of atrial fibrillation did not have atrial fibrillation perioperatively. The median follow-up was 26 months. There were only two in-hospital deaths (0.9%). Recurrences occurred in 18.2% of the patients with a mean time of 1.5(±1.0) years after surgery (local: 62.7%/1.7 years; distant: 37.3% 1.3 years). The overall mortality rate was 12% with 90 day mortality of only 1% (unrelated to the procedure). The 1 and 3-year overall survival was 96.6% and 93.8% for stage I, 93.7% and 73.9% for stage II and 97.1% and 52.2% for stage III. The 1 and 3-year disease-free survival was 96.3% and 89.8% for stage I, 93.4% and 68.8% for stage II and 96.7% and 52.7% for stage III.
Conclusion:
Our data suggests that over the last several years the rate of complications, need for ICU admission, length of hospital stay and overall mortality associated with the VATS anatomical resection for all stages of NSCLC has decreased in comparison with reported analysis from national data. In our series the 1-year and 3-years survival of VATS anatomical resection are similar to the reported data for open thoracotomy.
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P3.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 211)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Localized Disease - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.02-002 - Long-Term Survival of Patients Undergoing Video Assisted Thoracoscopic Anatomical Resection for Stage I NSCLC Is Equivalent to Open Thoracotomy (ID 2514)
09:30 - 09:30 | Author(s): U. Bokhary
- Abstract
Background:
We analyze the long-term survival of patients that underwent video assisted thoracoscopic (VATS) anatomical lung resection for Stage I Non-small cell carcinoma (NSCLC) of the lung before at the Northshore University Health System
Methods:
This is a retrospective analysis of data from patients that underwent VATS lung anatomical resection before December 31st of 2010.We extracted the data through standard queries and by manual extraction from the Electronic Data Warehouse of the Northshore University Health System. The patients were selected based on surgical description of anatomical resection defined as lobectomy, bilobectomy or segmentectomy for proven NSCLC. Patients with more than one procedure performed, diagnosis of carcinoid tumor or incomplete data were excluded. The variables evaluated included demographics, preoperative workup and clinical evaluation, pathology reports, intra-operative data and post-operative outcomes and 3 and 5 years overall and disease free survival.
Results:
A total of 265 patients were included. The mean age at the time of diagnosis was 70.9 (±9.9) years, 68.5% were female, 84.3% were Caucasian with a 39.6 (±26.3) pack year smoking history. The most common comorbidities encountered were hypertension (66.3%), COPD (34.8%) and coronary artery disease (28.1%). VATS lobectomy was performed in 90% of the patients. FEV~1~ data was available in 91.1% of the patients whereas DLCO data was available in 84.3% of the patients that underwent VATS anatomical resection. The mean procedure time was 151 (±59) minutes; the median length of chest drainage with tube thoracostomy was 3 days. Eighteen (20.2%) patients required admission to the Intensive Care Unit (ICU) with a median length of stay in the ICU of 2.2 days. The median length of stay in the hospital was 3.6 days. There were no deaths within 90 days post-surgery. The overall rate of complications was 25.8% with prolonged air leak (>5 days) (11.2%) and atrial fibrillation (9.0%) being the most frequent complications. The rate of adverse events decreased over time from 27.8% in 2008 to 20% in 2010. Only one patient required a second intervention within 30 days of the first surgery for a persistent chylothorax. The median follow-up was 57 months. Recurrences occurred in 10.2% of the patients with a mean time of 1.7 (±1.0) years after surgery. Local recurrence occurred in 68.4% of the times 1.9(±1.09) years after surgery whereas distant recurrences occurred in 31.6% of the times 1.4(±0.89) years after surgery. Overall mortality was 16%. The 3- and 5-years overall survival was 86% and 76.2%. The 3 and 5-years disease-free survival was 86.8% and 82.2%
Conclusion:
VATS anatomical lung resection does not seem to affect the long-term survival in comparison with reported analysis for open thoracotomy for patients with stage I NSCLC. Our data demonstrated a decreasing rate of complications with a high rate of cure for this group of patients, which might be utilized to compare with nonsurgical therapy for NSCLC
